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332 > Maternity > Flashcards

Maternity Flashcards

1
Q

How do chronic illnesses change during pregnancy?

A

They are exacerbated

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2
Q

Most medications for chronic diseases are…

A

teratogenic

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3
Q

How do chronic diseases affect fetal growth and why?

A

IUGR d/t decreased placental perfusion

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4
Q

How may medication doses need to be adjusted during pregnancy?

A

Increased

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5
Q

How much does a woman’s blood volume increase during pregnancy? When does this peak?

A

30-50%

28-32 weeks

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6
Q

What weeks are a CV problem most likely to present?

A

28-32

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7
Q

Is warfarin teratogenic?
Digoxin?
Heparin

A

Yes

No, no

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8
Q

Who must be involved when a CVD is present during pregnancy?

A

cardiologist, OB

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9
Q

What kind of findings indicate a CV problem

A

Edema beyond feet
SOB not readily relieved
Increased # of pillows at night
Chest pain

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10
Q

What intervention during labor for a CVD?

A

No pushing with contractions, epidural anesthetic

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11
Q

What post partum interventions for one with CVD

A

anticoagulants, digoxin, TEDS, abs, stool softener

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12
Q

2 things to inform mom of when she is pregnant with a pre existing illness

A 
promote rest (2/day, left lateral)
promote healthy nutrition (prenatal vitamins, iron supplements)
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13
Q

What are the 3 goals when a pre existing illness is at play

A

grow the baby
increase placental perfusion
increase mom’s energy

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14
Q

What may the baby be born with/how when a CVD is present

A

low birth weight
preterm labour
CS may be necessary

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15
Q

what kinds of anticoagulants do not cross placenta?

A

LMWH (dalteparin)

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16
Q

RSHF in pregnancy symptoms

A

hepatomegaly causing dyspnea

peripheral edema

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17
Q

How does anemia affect birth weight?

A

Decreases d/t decreased placental perfusion

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18
Q

What level of Hgb is concerning and what to do?

A

<110

ask mom if she has symptoms and if she knows how to increase the value

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19
Q

How much does Fe a healthy pregnant woman need a day? How much does an anemic woman?

A

27 mg/day

120-400 mg/day

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20
Q

Common side effect of Fe supplements? How to combat them?

A

Increase fibre and stool softeners

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21
Q

How to increase Fe absorption

A

Vit C, OJ

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22
Q

What lifestyle changes must an anemic pregnant woman make?

A

Rest periods, limiting exercise/work

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23
Q

What is another name for folic acid deficient anemia?

A

megloblastic anemia

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24
Q

Why is folic acid so necessary during pregnancy?

A

Form RBCs

Prevents neural tube/abdominal wall defects in the fetus

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25
Q

How much folic acid should a pregnant woman have/day

A

400 mcg/day

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26
Q

In a sudden pregnancy complications, how often are VS done? What other assessments?

A

q 5-15 mins

STAT BW, EFM, output

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27
Q

What is the presenting symptom of a SA?

A

vaginal bleeding

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28
Q

Causes of SA?

A 
abnormal development
implantation abnormalities
alcohol
UTIs
systemic infections
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29
Q

What is a complication of SA? How is it avoided?

A

Infection r/t retained POC, Abx/D&C

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30
Q

Which weeks is bleeding serious for a SA?

A

6-12

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31
Q

Bleeding during pregnancy is

A

always a deviation from normal

always potentially serious as it may indicate a SA

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32
Q

When can bleeding due to SA be life threatening?

A

after 12 weeks

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33
Q

What is the most common cause of painless bleeding in the third trimester?

A

Placenta previa

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34
Q

What is the greatest concern in placenta previa?

A

Hemorrhage

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35
Q

When is a CS necessary during placenta previa?

A

> 30%

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36
Q

Which pregnancy complication are PV exams prohibited?

A

Placenta previa

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37
Q

Which medication is given during placenta previa and why?

A

Betamethasone to mature baby’s lungs if preterm delivery is to happen

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38
Q

What is abruptio placentae?

A

Premature separation of the placenta = bleeding

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39
Q

What kind of pain during abruptio placentae? Is there always pain? Why/why not

A

sharp stabbing pain at fundus

no if concealed

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40
Q

What is the most common cause of perinatal death?

A

Abruptio placentae

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41
Q

What 3 risks abruptio placentae?

A

DIC
amniotic fluid embolus
hemorrhage

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42
Q

What 2 interventions are necessary during abruptio placentae?

A

emergency delivery

check for neonatal hypoxia at birth

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43
Q

What is preterm labor?

A

Labor occurring before end of week 37

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44
Q

Causes of PTL?

A

DEHYDRATION
UTI
interpartner violence/abuse
Low SE status

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45
Q

What indicates actual labor vs braxton hicks?

A

> 4 contractions in 20 minutes

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46
Q

5 interventions for PTL

A

Bed rest
IV fluids
terbutaline (tocolytic)
betamethasone

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47
Q

What is a major risk in PROM

A

infection, cord prolapse

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48
Q

What is the fluid in PROM tested for?

A

Ferning

Nitrazine paper

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49
Q

How often are vitals taken in PROM

A

q4 h for signs of infection

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50
Q

3 interventions PROM

A

IV Abx, bedrest, betamethasone

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51
Q

5 interventions cord prolapse

A 
do an internal exam
take fetal HR
keep mom LL/butt up in air
sterile glove, push baby's head off cord
cord soaked in saline gauze if external
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52
Q

What causes gestational hypertension?

A

VASOSPASM

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53
Q

What in mm hg is gestational HTN?

A

30 above baseline

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54
Q

3 cardinal signs of preeclampsia?

A

140/90, proteinuria, edema (up legs, eyes, sacrum)

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55
Q

Assessments during gestational HTN?

A 
headache
visual changes
epigastric pain
hyperreflexia
urine protein
creatinine
LFTs
clonus
daily weight
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56
Q

Tx of gestational HTN

A

anti platelet
bed rest
MgSO4
labetolol

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57
Q

What sign indicates an impending seizure?

A

signs of clonus

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58
Q

Why is MgSO4 given during preeclampsia?

A

to prevent seizures

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59
Q

3 features of HELLP

A

hemolysis, elevated LFTs, low platelets

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60
Q

What is the tx of HELLP

A

delivering baby, transfuse fresh frozen plasma/platelets

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61
Q

What is a precursor to HELLP?

A

Preeclampsia

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62
Q

Important assessments/lab values during a high risk pregnancy?

A

EFM
platelets (worried about DIC)
D-dimer (has mom’s blood mixed with baby’s)
Hgb/Hct

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63
Q

What indicates true anemia?

A

Hit <33%

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64
Q

How will Hct/Hgb change during pregnancy?

A

Decreased d/t hemodilution

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65
Q

What is the tx for GERD

A

PPI (esomeprazone, rat B)

wear loose clothing, sleep with head elevated

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66
Q

What kinds of hepatitis are/arent transmitted to fetus?

A

A = no

B & C - yes

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67
Q

Tx for hepatitis during pregnancy

A

Bed rest, high calorie diet, CS

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68
Q

Is a mom with hepatitis able to breastfeed?

A

Yes

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69
Q

What interventions once a baby is born to a mom with hepatitis?

A

Wash infant well
hepatitis B IG
1st dose hepatitis B vaccine administered

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70
Q

Why does cholecystitis happen during pregnancy?

A

hypercholesterolemia happens early in pregnancy leading to formation of gallstones

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71
Q

Tx cholesystisis?

A 
Lower fat intake
Rest GI tract temporarily 
IV fluids
Analgesics
Laproscopic sx to remove stones if needed
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72
Q

What mental illness meds may be teratogenic?

A

lithium

SSRIs

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73
Q

Why does antiphospholipid antibody syndrome cause a woman to miscarry?

Tx?

Risks postpartum?

A

coagulation in placental veins = growth blocked = MCs/HTN

prevention = ASA 81 mg, subcut heparin, prednisone

DVT

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74
Q

Where are most ectopic pregnancies implanted?

S/S?

Why is hemorrhage a concern?

What medication to treat?

A

fallopian tube

bleeding, sharp abd. pain

ruptured BVs, intraretroperitoneal bleeding

methotrexate

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75
Q

What is hydatiform mole?

A

abnormal proliferation of trophoblasts (associated with choriocarcinoma) malignant

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76
Q

What is cervical cerclage?

A

Sutures to strengthen cervix and prevent it from dilating until end of pregnancy in the case of cervical insufficiency

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77
Q

Why are multiple gestations a concern?

A

More susceptible to gestational HTN, hydramnios, placenta previa, PTL, anemia, post partum bleeding, low birth weights

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78
Q

What is the normal amount of amniotic fluid for a woman to have? How much does she have with hydramnios?

A

500-1000 mL @ term

>2000 mL

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79
Q

What causes hydramnios?

A

difficulty of fetus to swallow/absorb, excessive urine production

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80
Q

What procedure will a woman with hydramnios receive?

A

Amniocentesis

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81
Q

What are the causes of oligohydramnios?

A

Bladder/renal disorder of fetus, severe IUGR

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82
Q

What should a nurse assess for in a neonate who had oligohydramnios?

A

Kidney disease and compromised lung development

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83
Q

What dangers to the fetus in a post term pregnancy?

A

Meconium aspiration, macrosomia

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84
Q

For the pregnant teen, what developmental task may be interrupted (Erikson) and how to help guide that?

A

Identity vs Role Confusion

Allow for independence from parents on health decisions

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85
Q

What approach should be taken when interviewing a teen on their HH?

A

Gain detailed info by digging deeper, as teens are very private/vague

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86
Q

7 complications associated with teen pregnancy?

A 
imbalanced nutrition
PPH
cephalopelvic disproportion
gestational HTN
iron deficient anemia
preterm labor 
low birth weight
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87
Q

Chromosomal risks associated with advanced maternal age and what test is done?

A

Down Syndrome

alpha fetal protein test

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88
Q

Complications associated with advanced maternal age

A

PPH
gestational HTN
FTP
SA/Stillbirth/PTL

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89
Q

Cocaine’s effect on the baby?

A

abruptio placentae, PTL, death, low FHR variability, intracranial hemorrhage, abstinence syndrome

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90
Q

What are the symptoms of abstinence syndrome?

A

tremors, irritability, rigidity

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91
Q

What will the baby addicted to amphetamines present like?

A

Jittery, feed poorly, growth restriction

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92
Q

Is breastmilk affected by amphetamines?

A

Yes, the drug is excreted into breast milk so no breast feeding

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93
Q

How does phencyclidine (PCP) affect fetuses?

A

Drug concentrates in fetal cells and is potentially injuries

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94
Q

How will a baby addicted to narcotics present?

A

opiate dependence, abstinence symptoms, low birth weight, meconium aspiration, able to cope with bilirubin d/t increased liver development

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95
Q

What are the abstinence symptoms of narcotic withdrawal?

A

N/V/D, abd pain, shivering, insomnia, jerking movements

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96
Q

How do inhalants effect the body? the fetus?

A

Respiratory and cardiac irregularities = fetal hypoxia

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97
Q

What effect does alcohol abuse have on the baby?

A

Fetal alcohol spectrum disorder

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98
Q

Risk factors for uterine rupture (5)

A

CPD, prolonged labor, abnormal presentation, multiple gestation, oxytocin too early

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99
Q

S/S uterine rupture

A

severe pain during contraction, 2 swellings on abdomen, hemorrhage, hypovolemic shock

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100
Q

Tx uterine rupture

A

fluid replacement, IV oxytocin

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101
Q

2 events that cause uterine inversion?

A

traction applied to the cord, pressure applied to funds when uterus not contracted

102
Q

3 signs of uterine inversion?

A

hemorrhage from vagina, protrusion from vagina, funds not palpable

103
Q

Interventions uterine inversion (6)

A

DC oxytocin, IV fluid, O2 via mask, VS, tocolytic drug IV, Abx

104
Q

Presentation of a women with an amniotic fluid embolism?

A

sharp chest pain, inability to breathe, pale, cyanotic, LOC

105
Q

What is amniotic fluid embolism associated with?

A

Induction of labor, multiple pregnancies, hydramnios

106
Q

Can amniotic fluid embolism be prevented? Why/why not?

A

No because it cannot be predicted

107
Q

placenta succenturiata

A

1+ accessory lobes to placenta
no fetal abnormalities
risk for hemorrhage

108
Q

placenta circumvallata

A

fetal side of placenta is covered with chorion

109
Q

battledore placenta

A

cord inserted marginally rather than centrally

110
Q

velamentous insertion of the cord

A

cord does not enter placenta directly, but rather separates into small vessles
found in multis
associated with fetal abnormalities

111
Q

vasa previa

A

umbilical vessels cross os, therefore deliver before baby

112
Q

placenta accreta

A

deep attachment of placenta to myometrium that placenta cannot peel off and deliver
hysterectomy or methotrexate may be indicated

113
Q

what are the two umbilical cord anomalies?

A

two vessel cord

unusual cord length

114
Q

What are the normal vessels in the umbilical cord?

A

1 vein, 2 arteries (3 vessels)

115
Q

When there is a two vessel cord, what abnormalities are associated? What nursing indications at birth must be done for all babies therefore?

A

Kidney & cardiac abnormalities

Inspection of the cord at birth

116
Q

What risks does a ++ short cord impose?

A

Premature separation of the placenta

117
Q

What risks does a ++ long cord carry?

A

Getting twisted/knotted, wrapped around fetus’ neck

118
Q

What hepatitis is most commonly associated with substance abuse?

119
Q

Why do illicit substances cause fetal effects? (in terms of the drug’s composition?)

A

small molecular weight

120
Q

When labor deviates from normal, what is the nurse to do?

A

Consult physician (OB/GP), communicate and act early

121
Q

1:1 nursing care during…

122
Q

What are the 2 phases of labor?

A

Latent & Active

123
Q

4 stages of labor/birth?

A

1 - laboring/dilation
2 - pushing, descent, delivery
3 - delivery of placenta
4 - hemostasis

124
Q

How long after the placenta delivers is 1:1 nursing needed?

125
Q

How long can the latent phase of labor last for?

126
Q

Which phase of labor features irregular contractions?

127
Q

When is the latent phase over?

A

When a regular contraction pattern is established and the cervix is 3-4 cm dilated

128
Q

What phase of labor are contractions strong and regular?

129
Q

What are the contractions like in duration/frequency in the active stage of labor?

A

q2-3 mins, last 60 seconds each

130
Q

How dilated is a woman in active labor?

131
Q

What causes dystocia?

A

Problems with any of the 4 P’s

132
Q

What does dystocia increase the risks for? (5)

A 
infection
hemorrhage 
uterine rupture 
fistula development
Infant mortality r/t inadequate oxygenation
133
Q

At what mmHg does the uterine force cause potential damage to the fetus/mom?

134
Q

How often should a labouring woman urinate?

135
Q

What can a full bladder lead to after birth?

A

hemorrhage

136
Q

How does constipation impact labor?

A

Can prevent the latent phase from progressing

137
Q

A woman with ketones in her urine during labor needs…

A

Dextrose IV/candy as glucose is low

138
Q

How do narcotics effect labor?

A

Can stop it

139
Q

Most important factor during labor for mom to continue healthy labouring?

A

** HYDRATION **

140
Q

What are normal contractions like?

A

3-4 in 10 minutes

Last 60 seconds with a 60 second resting tone

141
Q

What length of contractions can cause fetal hypoxia?

A

> 60 seconds

142
Q

How should multips/primips dilate?

A

after 3-4 cm dilation:
M = 1 cm/hr
P = 1-1.5 cm/hr

143
Q

When is oxytocin given during labor?

A

When dilation is not at normal rate (too slow) , hypotonic contractions, uncoordinated contraction

144
Q

What is the risk of rapid dilation/hypertonic contractions?

A

Hypoxic infant

Hemorrhage

145
Q

What is the risk of precipitate labor (rapidly progressing labor)

A

Abruptio placentae

146
Q

If labor is taking too long (hypotonic/slow dilation) what is the risk and what is the tx?

A

Infection & hemorrhage

Oxytocin drip

147
Q

What 2 kinds of babies often present for the mom with CPD

A

gestational diabetes (baby too large for pelvis) or overdue babies (plates in head start to fuse)

148
Q

What is the risk of CPD on the uterus?

A

Uterine rupture

149
Q

What is a pathological contraction ring and what is done if palpated?

A

palatable ring across abdomen across umbilicus, get OB involved, C/S indicated

150
Q

What are 4 things the nurse should anticipate during a complicated labor?

A

Hemorhage
Exhaustion
Fetal distress
Infection

151
Q

Is a transverse (shoulder) lie deliverable?

152
Q

What positions/lies are deliverable

A

Longditudinal (cephalic, breech)

153
Q

What variation of breech is unstable and why?

A

incomplete breech

d/t risk for prolapse of cord

154
Q

What variations of breech are deliverable?

A

Frank, complete

155
Q

What are we worried about with breech babies?

156
Q

What presentation will give woman ++ back pain (“back labor”)

A

Occiput posterior

157
Q

What is the best presentation

A

occiput anterior

158
Q

What fetal problem is associated with shoulder dystocia?

A

Macrosomia

159
Q

What is intervention acronym for shoulder dystocia?

A

HELPER

H = call for help 
E = query episiotomy 
L = legs into mcroberts
P = pressure 
E = enter (physician breaks clavicle)
R = rotate (mom onto hands/knees)
160
Q

What is shoulder dystocia?

A

Head is born but shoulder is stuck

161
Q

How often is auscultation done during the first and second stages of labor?

A

Q15 for first

Q5 for second (pushing)

162
Q

How much variability is good for EFM?

163
Q

How much/many accelerations is good in EFM?

A

> 15 bpm above baseline for >15 seconds

164
Q

What do early decelerations indicate?

A

head compression

165
Q

What do late decelerations indicate?

A

fetal hypoxia

166
Q

What causes variable decelerations in EFM?

A

cord compression

167
Q

In EFM, what findings are worrisome?

A

Late decelerations and a loss of variability

168
Q

What are indications for a forceps birth? 3

A

late decelerations
failure to progress
mom fatigued and not able to push

169
Q

What are the 2 risks associated with a forceps birth?

A

Cranial nerve damage
Hematoma
Bladder damage for mom

170
Q

What are the indications for a vacuum extraction?

A

Close to delivery and mom can push

Baby is not preterm

171
Q

What are the associated risks with a vacuum extraction?

A

subdural hematoma

neurological decline

172
Q

Instrumentation does what for mortality rates?

173
Q

What length of time of pushing warrants consults and investigation?

A

Over 2 hours

174
Q

What factors predispose women to DVTs

A

increased fibrinogen
vessel dilation
estrogen

175
Q

Which women are at risk for DVTs

A

inactive in labor/postpartum
Pre existing obesity/varicose veins
Post partal infection
Cigarette smoking

176
Q

Prevention of mastitis

A

Good latch and unlatch baby before removal from breast
Good HH
Expose nipples to air
vit E ointment

177
Q

What organisms are associated with nosocomial mastitis?

A

Staph aureus, candidiasis

178
Q

Assessment findings with mastitis

A

breast pain/swelling unilaterally
fever
scant breast milk

179
Q

Tx for UTIs

A

amoxicillin/ampicillin

180
Q

Which abx for cutis is contraindicated and why?

A

sulfa drugs, as they cause neonatal jaundice in BF babies

181
Q

Which babies are at risk for RDS

A

preterm, macrocosmic, CS babies

182
Q

When does surfactant usually form?

A

34 weeks gestation

183
Q

SS RDS

A

low temp, nasal glaring, tachypnea (>60)

184
Q

Risk of oxygen administration in neonates

A

retinopathy of prematurity

185
Q

Cause of TTN

A

retained lung fluid not allowing proper O2 exchange

186
Q

What is the normal resp rate for newborns? What is it in TTN?

A

30-60

80-120

187
Q

Which babies are at risk for TTN

A

CS, mom has had lots of fluid in labor, preterm babies

188
Q

When should TTN resolve

A

72 hours of life

189
Q

What causes MAS

A

Hypoxia leading to vagal stimulation. This relaxes the anal sphincter and the baby mec’s in the AF. The baby then aspirates the mec

190
Q

Why is MAS a concern?

A

aspiration of meconium leads to respiratory distress, secondary infection = pneumonia

191
Q

What are the S/S of MAS

A

hypoxemia, tachycardia, retraction, low Apgar, acidosis

192
Q

What causes hemolytic disease of the newborn?

A

ABO incompatibility

mom is Rh neg and baby is Rh +

193
Q

What is hydrops fetalis?

A

Severe edema in the fetus (third spacing)

194
Q

Why are high bilirubin levels dangerous?

A

can cause brain damage

195
Q

How do successful feeding and phototherapy help treat hyperbilirubinemia?

A

Early feeding allows for elimination of bowels and therefore bilirubin

Light triggers the liver to process bilirubin for excretion

196
Q

What are the normal TsB levels? When do those levels become dangerous?

A

0-3 mg/100 mL

>20 mg/dL

197
Q

why does hemorrhagic disease of the newborn happen?

A

Deficiency of vitamin K

198
Q

What medication is given to prevent hemorrhagic disease of the newborn?

199
Q

What is NEC?

A

Bowel develops necrotic patches leading to impeded digestion. Can cause ileus, perforation, and peritonisis. D/t anoxia to bowel (breathing difficulty)

200
Q

What causes retinopathy of prematurity?

A

Vasocontriction of immature retinal BVs

201
Q

What does dystocia put the mom at risk for?(3)

A

PPH
Infection
PPD

202
Q

How often is the funds assessed for postpartum and how long?

A

q 5-15 mins for the first 4 hours

203
Q

How should the fundus move in regards to each postpartum daY?

A

Should be 1 finger breadth below umbilicus per day (day 0 = at umbilicus)

204
Q

How is the fundus assessed?

A

With who hands

205
Q

If the fundus is above where is should be what does the nurse do? What to do if this doesn’t help?

A

Fundal massage to expel blood to prevent PPH

Call doc for order for oxytocin

206
Q

If the fundus is found to the side, what does this mean, how can it be prevented, and what can it cause?What is the primary intervention?

A

bladder is full
get mom to void q2h
PPH

PUT IN A CATHETER!!!

207
Q

The first day, the loch should saturate pads completely. T/F?

208
Q

How often should we be changing pads?

209
Q

What colour should loch rub be?

210
Q

What does the assessment of the post portal woman always start with?

A

FUNDUS/LOCHIA

then VS

211
Q

When do most PPHs happen?

A

First 24 hours. Mostly within the first 4 hours

212
Q

What causes late PPH

213
Q

What causes most PPH?

A

UTERINE ANTONY

214
Q

If you suspect a PPH, what are your interventions in order?

A 
Fundal massage
Call for help, call Dr
VS
Lower HOB
IV NS/LR (16-18 g)
Administer oxytocin as ordered 
Catheter/void
215
Q

What are the 4 PPH drugs used in what order?

A

Oxytocin
Misoprostil
Ergometrine
Hemabate

OMEH

216
Q

What does misoprostil do?

A

Rectal tablet of prostaglandin derivative that causes uterus to tighten

217
Q

What does ergometrine do and how is it given

A

Injection

similar to oxytocin but different mechanism

218
Q

How does hemabate work? Side effects?

A

Smooth muscle contraction. Will have diarrhea/nausea

219
Q

What is the LAST LAST resort in a PPH?

A

Hysterectomy

220
Q

What 3 interventions will help cure a PPH most of the time?

A

Fundal massage
catheterization
oxytocin

221
Q

How can a full bladder effect the uterus?

A

Can cause uterine antony and therefore PPH

222
Q

How will a septic person’s temperature present?

223
Q

How high will a woman with a PPI’s WBCs be

224
Q

What are the differences between lactogenesis symptoms and infection symptoms?

A

foul smelling lochia
High fever (low for lacto)
increase in bleeding few days postpartum

225
Q

What are the 3 main focuses in the newborn nursing care?

A

Respirations
Extrauterine circulation
Temperature (thermoregulation)

226
Q

If a baby is exposed to GBS what is the baby at risk for? How is this prevented?

A

Meningitis

Abx during labor

227
Q

TORCH infections?

A 
Toxoplasmosis
Other (chicken pox/syphilis)
Rubella 
Cytomeglaovirus
Herpes Simplex
228
Q

If your rubella titre is low, what will happen?

A

You will be vaccinated when you are discharged from MB. Cannot give while pregnant as this vaccine can cause deafness and mental retardation in babies

229
Q

When are apgar scores taken?

A

1, 5 and 10 minutes

230
Q

What makes up the apgar score?

A

HR, Tone, Reflex irritability, color, respiratory effort

231
Q

1 minute apgar.. what score indicates the baby is having a hard time adjusting? what score indicates the baby needs to be in the NICU?

232
Q

5 minute apgar = what score does the baby need to have 1:1 NICU nursing?

233
Q

Which babies will be more mucousy?

A

CS babies, babies born in precipitate labor

234
Q

What will a baby who’s mom had gestational diabetes BG be

235
Q

Healthy babies need what interventions at birth?

A

Rubbed dry

Kept warm

236
Q

What 3 valves close in the fetal circulation?

A

ductus arteriosus
foramen ovale
ductus venosus

237
Q

what do the ductus arterioles and foramen ovale do?

A

shunt blood to the lungs

238
Q

What causes the FA/DA to stay/come back open?

A

cold stress/hypoglycemia

239
Q

What will result from the FA/DA not closing?

A

acidosis, respiratory distress/failure as it is a return to fetal circulation

240
Q

What timeframe is the most important for keeping the baby warm and the BG stable? Why?

A

First 18 hours of life

to ensure the FA//DA close

241
Q

What does surfactant do?

A

Reduces surface tension

242
Q

If the surfactant ratio is not right (premature?) what will happen?

A

Weak/underdeveloped lung musculature and lungs will not be able to expand

243
Q

What drug changes the surfactant ration to be more appropriate (like a term baby’s?)

A

betamethasone

244
Q

What kind of ventilation is given to babies that are premature?

A

CPAP (expands alveoli)

245
Q

What factors lead to respiratory distress in preterm infants?

A

Decreased surfactant/lung maturity
Cold stress/acidosis
No brown fat

246
Q

What 4 ways is heat lost?

A

Convection
Radiation
Conduction
Evaporation

247
Q

what amount of blood loss is significant in a newborn?

248
Q

What can macrosomia cause in the newborn?

A

Respiratory distress

249
Q

What do low BS contribute to?

A

Acidosis.. impedes then on respiratory function

250
Q

How are macrocosmic babe supported?

A

Freq BG
Supplemental feeds
IV
O2

332 (2 decks)

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